Provider Demographics
NPI:1790852887
Name:YEARICK, DANIEL SCOTT (LPC)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:SCOTT
Last Name:YEARICK
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 509
Mailing Address - Street 2:
Mailing Address - City:WAYNESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28786-0509
Mailing Address - Country:US
Mailing Address - Phone:828-456-4588
Mailing Address - Fax:828-456-4150
Practice Address - Street 1:563 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786-3817
Practice Address - Country:US
Practice Address - Phone:828-456-4588
Practice Address - Fax:828-456-4150
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2850101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6102730Medicaid
NC1109AOtherBLUE CROSS BLUE SHIELD